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Weighing the Pros and Cons of Stevia

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Stevia leaf extract, known as stevia, is a natural, zero-calorie sweetener used as a sugar substitute. It is derived from the leaves of the Stevia rebaudiana plant and has been used for centuries in South America.

Although rare, side effects of stevia can include gastrointestinal symptoms, decreased blood pressure and blood sugar, and potential impacts on the liver. The Food and Drug Administration (FDA) considers stevia leaf extract safe for consumption and unlikely to cause side effects in most people.

This article discusses the different forms of stevia and the side effects of this sugar alternative.

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Is Stevia healthy or not?

Stevia is a calorie-free sweetener extracted from Stevia rebaudiana plant. There are 11 steviol glycosides in the stevia leaf, responsible for giving stevia its sweet flavor.

Known vs Unknown

Stevia is available in a few different forms. Some of them are safe for consumption, while others have not been carefully evaluated for their safety. Forms include:

  • Green stevia leaf is the purest form of stevia. However, that doesn’t mean it’s the healthiest. Stevia leaf has not been studied enough to be considered safe for consumption, and the FDA does not approve its use in food.
  • Stevia leaf extract is a form of stevia made by drying the leaves of the plant, soaking them in hot water, then straining and purifying the extract. The result is a product known as purified steviol glycosides. To meet FDA standards, stevia leaf extract must contain more than 95% steviol glycoside. Stevia leaf extract in this form is generally recognized as safe by the FDA.
  • Stevia blends include branded products such as Truvia and Stevia in the Raw and are more processed. They are made by combining stevia leaf extract with other sweeteners or sugar alcohols. These products are also safe to consume, although they may cause side effects in people sensitive to sugar alcohol.

Stevia is much sweeter than sugar and can be up to 250 to 300 times sweeter than sucrose, the molecule in table sugar. Despite this, stevia has no calories or carbs, unlike sugar which has 15 calories and 4 grams of carbs per teaspoon.

Stevia may be a healthy option for those looking to reduce their calorie or carbohydrate intake, such as people with type 2 diabetes. However, some studies suggest that consuming non-nutritive sweeteners such as stevia instead of sugar does not reduce overall calorie intake or blood sugar.

How does stevia compare to other calorie-free sweeteners?

Another popular calorie-free sweetener is sucralose, sold under the brand name Splenda. Sucralose is derived from sugar in a chemical process and is 400 to 700 times sweeter than sugar. However, animal studies have linked sucralose to cancer and disturbances in the gut microbiome.

Although research on the long-term effects of stevia is limited, there is no evidence that it causes cancer. Sucralose can be particularly carcinogenic (causing cancer) when heated, so stevia may be a healthier option for cooking.

Stevia Side Effects

Stevia does not cause side effects in most people. However, some may experience the following when consuming products sweetened with stevia:

  • Gastrointestinal symptoms: Sugar alcohols, sometimes added to stevia products, can cause nausea, vomiting, diarrhea, bloating and abdominal pain in people sensitive to sugar alcohol. However, Stevia itself is not known to cause gastrointestinal issues.
  • Low blood pressure: Stevia has been shown to lower blood pressure in people with hypertension (high blood pressure). There is no evidence to suggest that stevia lowers blood pressure to dangerous levels in those with normal levels. However, those taking antihypertensive medications should be aware of stevia’s potential to enhance the effects of the medication.
  • Hypoglycemia: Stevia has the potential to lower blood sugar (blood sugar), especially in those who use it as a sugar replacement. Consuming too few carbohydrates can lead to hypoglycemia, leading to headaches, dizziness, tremors and other symptoms.
  • Side effects on the liver: Research on the impact of stevia on the liver is preliminary and inconclusive. A mouse study found an association between stevia and sucralose that raised liver enzymes. However, other human studies suggest that stevia may help reduce markers of fatty liver disease.

Does stevia cause cancer?

Early studies on stevia suggested it was linked to cancer, prompting the FDA’s initial ban in 1991. However, subsequent research led the FDA to rescind the ban, as hundreds of studies failed. showed no increased risk of cancer from stevia consumption.

Dosages

Although stevia leaf extract is generally recognized as safe, the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) have formed the Joint FAO/ WHO Experts on Food Additives (JECFA), which has set an Acceptable Daily Intake (ADI) for consumption. The ADI is the maximum average daily dose of a substance over a person’s lifetime that is expected to be safe. It is based on extensive research.

Is stevia good to consume every day?

It is safe to consume stevia every day. However, the ADI for steviol is 4 milligrams (mg) per kilogram of body weight per day. This equates to approximately 12 mg per kilogram (kg) of Stevia extract per day. For a 150 pound person, that would equate to about 40 packets of stevia.

Although this high level of consumption is generally not recommended, it demonstrates the vast volume of stevia you would need to consume for it to be considered unsafe.

Contraindications

Stevia is safe for most people. However, since stevia can have hypotensive and blood sugar-lowering effects, as well as diuretic effects, those taking certain medications or have certain health conditions should consult their health care provider before consuming significant amounts of stevia.

People most likely to experience side effects from stevia include people taking medications to lower blood pressure or blood sugar or those diagnosed with:

Stevia during pregnancy and lactation

Stevia leaf extract is safe to consume while pregnant or breastfeeding. However, whole leaf stevia is not FDA approved and generally not recognized as safe for consumption by anyone, especially pregnant women.

Summary

Stevia is a calorie-free, non-nutritive sweetener made from Stevia rebaudiana the leaves of the plant. Although most people experience no side effects from consuming them, stevia blends containing sugar alcohols may cause gastrointestinal symptoms in people sensitive to sugar alcohols.

Stevia also has hypotensive and blood sugar lowering effects, so people taking certain medications or conditions should speak with their health care provider before using stevia for an extended period of time.

A word from Verywell

If you are concerned about the potential side effects of stevia, research shows that it is safe to consume and unlikely to cause side effects in most people. It can be hard to know which foods are healthy with so many options available today, but eating a balanced diet and consuming sugar and other sweeteners in moderation is the best way to keep your body healthy while continuing to enjoy the foods you love.

Frequently Asked Questions

  • Has the FDA banned stevia?

    In 1991, the FDA banned stevia over fears it was linked to cancer. However, the FDA rescinded the ban in 1995 after a follow-up study found no link. Stevia leaf extract (over 95% steviol glycosides) was determined to be generally recognized as safe in 2008 by the FDA.

  • Does Stevia cause inflammation?

    Stevia is not known to cause inflammation. Some studies suggest it may have anti-inflammatory properties, although more research is needed to determine the magnitude of this effect.

  • Are the benefits of Stevia better than sugar?

    Stevia has no calories or carbs, while sugar has 15 calories and 4 carbs per teaspoon. However, studies suggest that consuming sugar substitutes such as stevia in place of sugar does not impact overall daily calorie intake or blood sugar levels.

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